This type of bodywork is not relaxation massage, or what is known as ‘passive treatment’. This is a paradigm shift from ‘relaxation’ to ‘realignment’. We will be engaged in a combination of ‘active assessment and treatment’ (hands-on bodywork and functional movement modalities) for approximately 90 minutes.
Orthopedic Massage (Waslaski) is a multimodal and multidisciplinary approach for evaluating and treating clients presenting with a wide variety of musculoskeletal disorders, chronic pain, sports injuries, and structural imbalances. It can be utilized by a variety of healthcare professionals including physical and occupational therapists, athletic trainers, personal trainers, strength and conditioning coaches, chiropractors, osteopaths, nurses, manipulative therapists, and physicians. Waslaski’s technique seeks to bridge all manual therapy disciplines through a unique 12-step approach based on soft tissue and structural balancing, which can be integrated as a model in most manual therapy training programs.
Waslaski’s 12-step approach is not considered a cookbook approach to manual therapy, but is a unique system that allows the therapist to quickly identify the key areas of pain and dysfunction so that appropriate treatment techniques can be matched to the underlying pathology. Consistent attention is given to restoring myoskeletal imbalance by correcting structural asymmetries prior to treating each individual clinical symptom. This process is also referred to in manual therapy literature as ‘normalizing the periphery’… As Ida Rolf would say, “First, put the tissue back where it belongs.”
The causes and contributing factors involved in myoskeletal pain are always addressed prior to treating and eliminating the client’s pain symptoms. In Waslaski’s model, the recommended treatment sequence is to first restore balance to opposing muscle groups throughout the body. This is accomplished by lengthening short, tight muscle groups and then tonifying the opposing weak, inhibited tissues. The most effective treatment protocol begins by addressing myofascial tension, tight muscle bands, muscle belly trigger points, scar tissue, joint capsule adhesions, and finally the resulting joint pain. Tight muscle bands can be teased apart by gentle cross-fiber gliding strokes, while trigger points are addressed by direct, moderate pressure, with all the work performed pain-free.
Waslaski’s approach to scar tissue also sets him apart from typical, conventional treatment methods, which recommend ‘deep cross-fiber friction’, in one direction only, to realign the scar tissue’s injured or disorganized fibers. An examination of the collagen fiber formation following injury reveals the potential problem with the conventional approach. Scar tissue being formed at the site of an injury consists of a fiberglass-like matrix of collagen fibers oriented in multiple directions and multiple layers, which result in pain and limited range of motion for the client. Simple cross-fiber friction does not mobilize multilayered/multidirectional fibers, effectively.
James recommends and teaches the much more effective technique of ‘multidirectional friction’, which works to mobilize the scar tissue by focusing on the softening of the thickest fibers in the collagen matrix, superficial to deep. This process is then followed by pain-free mobilization, pain-free eccentric muscle contractions, and pain-free stretching/strengthening to better facilitate functional and more aligned scar tissue. This unique strategy makes it possible for the area of scar tissue to remain smooth to palpation after treatment, enabling the client to remain pain-free following treatment.
Waslaski suggests that no single modality is the answer for treating all conditions. Rather it is the synergy of many modalities and disciplines integrated together that allows the therapist to treat each client in a truly individualized manner.